Acar Rezzan Deniz, Acar Şencan, Gürcü Mustafa Emre, Doğan Cem, Bayram Zübeyde, Uysal Samet, Güvendi Büşra, Yaşar Akbal Özgür, Kaymaz Cihangir, Kaan Kırali Mehmet, Özdemir Nihal
Department of Cardiology, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey.
Department of Internal Diseases, Division of Gastroenterology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2022 Jan 28;30(1):1-7. doi: 10.5606/tgkdc.dergisi.2022.22254. eCollection 2022 Jan.
This study aims to investigate the association between right atrial pressure and the Model for End-Stage Liver Disease score and to evaluate the ability of this scoring system to accurately predict the value of right atrial pressure.
Between April 2016 and November 2018, a total of 137 patients (118 males, 19 females; median age: 49 years; range, 40 to 54 years) with advanced heart failure who were candidates for left ventricular assist device implantation or heart transplantation were retrospectively analyzed. We developed a formula calculated by using the biochemical and cardiac catheterization parameters of the patients.
There was a strong correlation between the right atrial pressure and the scores (r=0.510, p<0.001). The estimated right atrial pressure was calculated as "2 + (0.92 x Model for End-Stage Liver Disease Score)" (unstandardized coefficient 0.920, t value 7.674, p<0.001). The Model for End-Stage Liver Disease score was found to be an independent predictor of high right atrial pressure (odds ratio=1.491, 95% confidence interval: 1.244-1.786, p<0.001). The calculated area under the curve was 0.789 (95% confidence interval: 0.710-0.867, p<0.001) and the cut-off value of the Model for End-Stage Liver Disease score in the prediction of high right atrial pressure was 10.5 with 75% sensitivity and 73% specificity.
We define a method to calculate right atrial pressure obtained by using the Model for End-Stage Liver Disease score without the need for cardiac catheterization during the hospitalization and follow-up period of patients with advanced heart failure.
本研究旨在探讨右心房压力与终末期肝病模型评分之间的关联，并评估该评分系统准确预测右心房压力值的能力。
回顾性分析2016年4月至2018年11月期间共137例晚期心力衰竭患者（118例男性，19例女性；中位年龄：49岁；范围40至54岁），这些患者均为左心室辅助装置植入或心脏移植的候选者。我们利用患者的生化和心导管检查参数制定了一个计算公式。
右心房压力与评分之间存在强相关性（r = 0.510，p < 0.001）。估计的右心房压力计算为“2 +（0.92×终末期肝病模型评分）”（未标准化系数0.920，t值7.674，p < 0.001）。发现终末期肝病模型评分是高右心房压力的独立预测因子（比值比 = 1.491，95%置信区间：1.244 - 1.786，p < 0.001）。计算出的曲线下面积为0.789（95%置信区间：0.710 - 0.867，p < 0.001），终末期肝病模型评分预测高右心房压力的截断值为10.5，敏感性为75%，特异性为73%。
我们定义了一种在晚期心力衰竭患者住院和随访期间无需心导管检查即可通过终末期肝病模型评分计算右心房压力的方法。
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